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Sahoo KC, Dwivedi R, Athe R, Chauhan A, Jain S, Sahoo RK, Bhattacharya D, Rajsekhar K, Pati S. Cost-effectiveness of portable-automated ABR for universal neonatal hearing screening in India. Front Public Health 2024; 12:1364226. [PMID: 39188791 PMCID: PMC11345169 DOI: 10.3389/fpubh.2024.1364226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 07/29/2024] [Indexed: 08/28/2024] Open
Abstract
The World Health Organization considers Universal Neonatal Hearing Screening (UNHS) essential to global public health. Rashtriya Bal Swasthya Karyakram has included newborn hearing screening in India since 2013. The program faces human, infrastructure, and equipment shortages. First-line hearing screening with improved diagnostic accuracy is needed. The Portable Automated Auditory Brainstem Responses (P-AABR) can be used in remote areas for UNHS due to its low infrastructure needs and diagnostic accuracy. This study evaluated the cost-effectiveness of P-AABR in UNHS. We employed an analytical model based on decision trees to assess the cost-effectiveness of Otoacoustic Emission (OAE) and P-AABR. The total cost to the health system for P-AABR, regardless of true positive cases, is INR 10,535,915, while OAE costs INR 7,256,198. P-AABR detects 262 cases, whereas OAE detects 26 cases. Portable Automated ABR costs INR 97 per case detection, while OAE costs INR 67. The final ICER was 97407.69. The P-AABR device is cost-effective, safe and feasible for UNHS Rashtriya Bal Swasthya Karyakram (RBSK) programs. Beyond reducing false referrals and parent indirect costs, it detects more hearing-impaired infants. Even in shortages of skilled workers, existing staff can be trained. Thus, this study suggests integrating this device into community and primary health centers to expand UNHS coverage.
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Affiliation(s)
- Krushna Chandra Sahoo
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Rinshu Dwivedi
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Ramesh Athe
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Akshay Chauhan
- Department of Health Research, Ministry of Health & Family Welfare, Health Technology Assessment in India (HTAIn), New Delhi, India
| | - Shalu Jain
- Department of Health Research, Ministry of Health & Family Welfare, Health Technology Assessment in India (HTAIn), New Delhi, India
| | - Rakesh Kumar Sahoo
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Debdutta Bhattacharya
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Kavitha Rajsekhar
- Department of Health Research, Ministry of Health & Family Welfare, Health Technology Assessment in India (HTAIn), New Delhi, India
| | - Sanghamitra Pati
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
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Sahoo KC, Athe R, Bhattacharya D, Dwivedi R, Sahoo RK, Aimol LW, Jain S, Rajsekhar K, Pati S. Use of Portable Automated Auditory Brainstem Responses in Universal Neonatal Hearing Screening: A Mixed-Method Study in Odisha, India. Indian J Pediatr 2023; 90:298-300. [PMID: 36598633 DOI: 10.1007/s12098-022-04435-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/13/2022] [Accepted: 11/03/2022] [Indexed: 01/05/2023]
Abstract
Hearing loss in children affects cognitive development, so early detection is crucial. It is because of the lack of portable technology that the majority of hearing problems go undetected. The authors conducted a mixed-method study in India to examine the concurrent validity and operational feasibility of portable automated brainstem response (P-AABR) and otoacoustic emissions (OAE) in universal neonatal hearing screening. They screened 198 children's ears using ABR and OAE devices. Additionally, 60 observations were recorded during the 'portable automated ABR' screening process. The hearing screening could be performed with P-AABR by any health care staff with basic skill-based training. However, the interpretation of the graphical wave required an audiologist. If the baby was quiet, the test could be performed in 20 min, including electrode implantation, impediment setting, earphone installation, and swipe counts. The P-AABR device can be used in the universal health coverage of hearing screening among infants in outreach areas due to its portability and minimal infrastructural requirements.
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Affiliation(s)
- Krushna Chandra Sahoo
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India.
| | - Ramesh Athe
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Debdutta Bhattacharya
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Rinshu Dwivedi
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Rakesh Kumar Sahoo
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Lanu Wanboy Aimol
- Ayjnishd (Divyangjan), Regional Center, Janla, Bhubaneswar, Odisha, India
| | - Shalu Jain
- Health Technology Assessment in India (HTAIn), Department of Health Research, Ministry of Health & Family Welfare, New Delhi, India
| | - Kavitha Rajsekhar
- Health Technology Assessment in India (HTAIn), Department of Health Research, Ministry of Health & Family Welfare, New Delhi, India
| | - Sanghamitra Pati
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
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